Provider Demographics
NPI:1346798808
Name:OPOKU, REBECCA
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:
Last Name:OPOKU
Suffix:
Gender:F
Credentials:
Other - Prefix:DR
Other - First Name:REBECCA
Other - Middle Name:
Other - Last Name:OPOKU
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHARMACIST
Mailing Address - Street 1:8631 NEUSE CLUB LN
Mailing Address - Street 2:APT 103
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27616-8038
Mailing Address - Country:US
Mailing Address - Phone:919-672-9710
Mailing Address - Fax:
Practice Address - Street 1:2830 GATEWAY DR
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:NC
Practice Address - Zip Code:27834-0138
Practice Address - Country:US
Practice Address - Phone:252-917-6165
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-09-13
Last Update Date:2016-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC26448183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist